Qualifying Life Event Checklist for Delayed Enrollment in ACA Coverage

Qualifying Life Event Checklist for Delayed Enrollment in ACA Coverage

Form for staff and clients to use in determining if they experienced a qualifying life event that would enable them to enroll in Affordable Care Act coverage after the March 31, 2014 end date for the 2014 open enrollment season. Form is based upon the HealthCare.Gov Health Care Screener Tool.